A De Garengeot Hernia masquerading as a strangulated femoral hernia.

Abstract

INTRODUCTION:

De Garengeot hernia is a rare occurrence whereby an appendix is found in a femoral hernia sac. It is rarer still to find an acutely inflamed appendix manifesting itself as a strangulated femoral hernia. This case is important to report as it highlights the diagnostic difficulty this particular condition presents to an emergency surgeon.

PRESENTATION OF CASE:

We report the case of an 86 year old female who was found to have a De Garengeot hernia containing a necrotic appendix. A retrograde appendicectomy was performed to prevent peritoneal contamination. The hernia defect was repaired using a standard repair with non-absorbable suture.

DISCUSSION:

De Garengeot's hernia is a rare occurrence, is often unexpected and tends to be diagnosed intra-operatively. Pre-operative diagnosis remains difficult and it will often masquerade as a strangulated femoral hernia. In stable patients, where there is a diagnostic uncertainty CT scanning is a useful adjunct and may allow a laparoscopic approach to be undertaken in the absence of appendicitis.

CONCLUSION:

A De Garengeot's hernia should be considered as a differential diagnosis in patients presenting with clinical signs of a strangulated femoral hernia. It is often an incidental finding during an emergency operation. Although mesh repairs in the presence of appendicitis have been reported, the safest approach remains a primary suture repair.

• Authors: A Hussain, A A P Slesser, S Monib, J Maalo, M Soskin, J Arbuckle
• Journal: International journal of surgery case reports (Int J Surg Case Rep) Vol. 5 Issue 10 Pg. 656-8 ( 2014) ISSN: 2210-2612 [Print] Netherlands
• PMID: 25194597 (Publication Type: Journal Article)
• Copyright: Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.